[논문]사람중심 치매커뮤니케이션에 대한 근거 이론적 연구

김동선; 신수경

doi:10.5392/jkca.2022.22.05.746

사람중심 치매커뮤니케이션에 대한 근거 이론적 연구
A Grounded Theory Approach to Person Centered Communication between People Living with Dementia and Their Caregivers 원문보기

한국콘텐츠학회논문지 = The Journal of the Korea Contents Association, v.22 no.5, 2022년, pp.746 - 764

김동선 (우송대학교 사회복지학과) , 신수경 (가톨릭대학교 사회복지대학원)

초록
AI-Helper

커뮤니케이션 장애는 치매 돌봄 부담의 주된 원인으로 지적되고 있다. 본 연구는 케어자와 치매노인 간의 커뮤니케이션 과정 및 결과를 구조화하여 커뮤니케이션의 촉진요인을 찾는 것을 목적으로 한다. 시설의 치매 케어자 21명을 대상으로 커뮤니케이션 직·간접 경험을 인터뷰해, 수집된 자료를 근거이론에 따라 분석하였다. 연구 결과, 치매인과의 커뮤니케이션 과정은 치매인의 인지·언어기능 저하가 원인으로 작용하지만, 소란스러운 환경이나 커뮤니케이션 기술 부족 등이 맥락적 조건으로 작용하여 커뮤니케이션 실패 현상이 이루어진다. 이때, 최소한의 접촉, 업무중심의 대화로 대응하는 경우, 갈등과 회피로 나아가는 부정적 커뮤니케이션이 이루어지는 반면, '개인에 대한 이해', '경청', '마음으로 이해' 등의 중재를 통해 긍정적 커뮤니케이션이 가능하다는 것을 확인했다. 중재적 조건에 따라 치매노인의 배회, 폭력적 행동이 악화되기도 하지만 반대로 치매인의 인지 능력이 개선되거나 즐거움 회복, 일상생활에의 참여 등 긍정적 결과가 나타났다. 본 연구에서의 핵심범주는 '관계 맺음을 통한 사람중심케어'이며 범주유형은 갈등형, 무시형, 보호형, 파트너형으로 나뉘어진다. 본 연구결과를 토대로 사람중심케어에 입각한 치매 커뮤니케이션 교육 및 훈련을 제언한다

Abstract ▼ AI-Helper

Communication breakdown has been mentioned causing a heavy burden for dementia caregivers. This study aims to inspect and structure the process and results of communication between people with dementia and their caregivers. The impeding/facilitating elements of communication are also extracted. Interviews with 21 of dementia care experts about the direct and indirect experiences of communication with people with dementia were analyzed based on the grounded theory. Results show that combination of the cognitive and communication decline of the people with dementia, confusing environment and caregivers' inappropriate attitude and lack of communication skills leads to communication breakdown and relations severance. Minimal contacts and task-oriented conversation results in conflicts and people with dementia's increasing agitation, anxiety and violent behaviors while understanding of individuality and listening with heart lead to recovered lucidity in the state of serious dementia, recovered pleasure and voluntary participation in the daily activities for people with dementia. Core paradigm was defined as 'Person Centered Care through relation formation'. There are 4 types of communication with people with dementia : partnering, patronizing, conflicting, avoiding types. Researchers suggest that Person Centered based communication skills be educated and trained for dementia caregivers.

주제어

참고문헌 (50)

M. Mentis, J. Briggs-Whittaker, and G. D. Gramigna, "Discourse topic management in senile dementia of the Alzheimer's type," Journal of Speech and Hearing Research, Vol.38, pp.1054-1066, 1995.

상세보기
D. G. Ellis, "Coherence patterns in Alzheimer's discourse," Communication Research, Vol.23, No.4, pp.472-495, 1996.

상세보기
J. Appell, A. Kertesz, and M. Fisman, "A study of language functioning in Alzheimer patients," Brain and Language, Vol.17, pp.73-91, 1982.

상세보기
P. A. Mayhew, G. J. Acton, S. Yauk, and B. A. Hopkins, "Communication from individuals with advanced DAT: can it provide clues to their sense of self-awareness and well-being?," Geriatric Nursing, Vol.22, No.2, pp.106-110, 2001.

상세보기
S. Ekman, A. Norberg, M. Viitanen, and B. Winblad, "Care of demented patients with severe communication problems," Scandinavian Journal of Caring Sciences, Vol.5, No.3, pp.163-170, 1991.

상세보기
M. Pepping and J. R. Roueche, "Psychosocial consequences of significant brain injury," In The neuropsychology of everyday life: Issues in development and rehabilitation Springer, Boston, MA, pp.215-256, 1991.
C. T. Beck, "Nursing students' experiences caring for cognitively impaired elderly people," Journal of Advanced Nursing, Vol.23, pp.992-998, 1996.

상세보기
Joseph B. Orange, "Perspectives of family members regarding communication changes," Dementia and communication, pp.168-186, 1991.
G. M. Williamson and R. Schulz, "Coping with specific stressors in Alzheimer's disease caregiving," The Gerontologist, Vol.33, No.6, pp.747-755, 1993.

상세보기
D. Cohen, "The subjective experience of Alzheimer's disease:The anatomy of an illness as perceived by patients and families," American Journal of Alzheimer's Care and Related Disorders and Research, Vol.6, pp.4-11, 1991.
L. Paquay, J. De Lepeleire, K. Milisen, M. Ylieff, O. Fontaine, and F. Buntinx, "Tasks performance by registered nurses and care assistants in nursing homes: a quantitative comparison of survey data," International Journal of Nursing Studies, Vol.44, No.8, pp.1459-1467, 2007.

상세보기
K. N. Williams, R. Herman, B. Gajewski, and K. Wilson, "Elderspeak communication: Impact on dementia care," American Journal of Alzheimer's Disease & Other Dementias®, Vol.24, No.1, pp.11-20, 2009.
M. Y. Savundranayagam, J. Sibalija, and E. Scotchmer, "Resident reactions to person-centered communication by long-term care staff," American Journal of Alzheimer's Disease & Other Dementias®, Vol.31, No.6, pp.530-537, 2016.
A. Miles and J. Asbridge, "Person-Centered Healthcare-moving from rhetoric to methods, through implementation to outcomes," European Journal for Person Centered Healthcare, Vol.5, No.1, pp.1-9, 2017.
G. J. Acton, S. Yauk, B. A. Hopkins, and P. A. Mayhew, "Increasing social communication in persons with dementia," Research and Theory for Nursing Practice, Vol.21, No.1, pp.32-44, 2007.

상세보기
Louis J. Medvene and Hannah Lann-Wolcott, "An exploratory study of nurse aides' communication behaviours: giving 'positive regard'as a strategy," International Journal of Older People Nursing, Vol.5, No.1, pp.41-50, 2010.

상세보기
T. M. Kitwood, Dementia reconsidered: The person comes first, Open university press, 1997.
N. G. Kutner, P. J. Brown, R. C. Stavisky, W. S. Clark, and R. C. Green, "'Friendship' Interactions and Expression of Agitation among Residents of a Dementia Care Unit: Six-Month Observational Data," Research on Aging, Vol.22, No.2, pp.188-205, 2000.

상세보기
L. Clare, J. Rowlands, E. Bruce, C. Surr, and M. Downs, "The experience of living with dementia in residential care: an interpretative phenomenological analysis," The Gerontologist, Vol.48, No.6, pp.711-720, 2008.

상세보기
홍현미라, 권지성, 장혜경, 이민영, 우아영, 사회복지 질적 연구방법론의 실제, 학지사, 2017.
J. A. Small, K. Geldart, and G. Gutman, "Communication between individuals with dementia and their caregivers during activities of daily living," American Journal of Alzheimer's Disease & Other Dementias®, Vol.15, No.5, pp.291-302, 2000.
Alzheimer's Association, "2016 Alzheimer's disease facts and figures," Alzheimer's & Dementia, Vol.12, No.4, pp.459-509, 2016.
J. J. Wang, P. F. Hsieh, and C. J. Wang, "Long-term care nurses' communication difficulties with people living with dementia in Taiwan," Asian Nursing Research, Vol.7, No.3, pp.99-103, 2013.

상세보기
M. P. Nichols, The lost art of listening: How listening can improve relationships, New York, 1995.
K. A. Talerico, L. K. Evans, and N. E. Strumpf, "Mental health correlates of aggression in nursing home residents with dementia," The Gerontologist, Vol.42, No.2, pp.169-177, 2002.

상세보기
E. B. Ryan, K. Byrne, H. Spykerman, and J. B. Orange, "Evidencing Kitwood's personhood strategies: Conversation as care in dementia," Alzheimer Talk, Text and Context, Palgrave Macmillan, London, pp.18-36, 2005.
Boyd H. Davis, and Cynthia Bernstein, "Talking in the here and now: Reference and politeness in Alzheimer conversation," Alzheimer Talk, Text and Context. Palgrave Macmillan, London, pp.60-86, 2005.
P. A. Saunders, K. de Medeiros, P. Doyle, and A. Mosby, "The discourse of friendship: Mediators of communication among dementia residents in long-term care," Dementia, Vol.11, No.3, pp.347-361, 2012.

상세보기
L. Orulv, "Placing the place, and placing oneself within it: (Dis) orientation and (dis) continuity in dementia," Dementia, Vol.9, No.1, pp.21-44, 2010.

상세보기
L. Orulv and L. C. Hyden, "Confabulation: Sense-making, self-making and world-making in dementia," Discourse Studies, Vol.8, No.5, pp.647-673, 2006.

상세보기
G. Hubbard, A. Cook, S. Tester, and M. Downs, "Beyond words: Older people with dementia using and interpreting nonverbal behaviour," Journal of Aging Studies, Vol.16, No.2, pp.155-167, 2002.

상세보기
L. Strandroos and E. Antelius, "Interaction and common ground in dementia: Communication across linguistic and cultural diversity in a residential dementia care setting," Health, Vol.21, No.5, pp.538-554, 2017.
Z. Mok and N. Muller, "Staging casual conversations for people with dementia," Dementia, Vol.13, No.6, pp.834-853, 2014.

상세보기
M. S. Bourgeois, K. Dijkstra, L. D. Burgio, and R. S. Allen, "Communication skills training for nursing aides of residents with dementia: The impact of measuring performance," Clinical Gerontologist, Vol.27, No.1-2, pp.119-138, 2004
T. Hopper, S. Cleary, N. Baumback, and A. Fragomeni, "Table fellowship: Mealtime as a context for conversation with individuals who have dementia," Alzheimer's Care Today, Vol.8, No.1, pp.34-42, 2007.
B. Hoeffer, K. A. Talerico, J. Rasin, C. M. Mitchell, B. J. Stewart, D. McKenzie, ... and P. D. Sloane, "Assisting cognitively impaired nursing home residents with bathing: effects of two bathing interventions on caregiving," The Gerontologist, Vol.46, No.4, pp.524-532, 2006.

상세보기
P. D. Sloane, B. Hoeffer, C. M. Mitchell, D. A. McKenzie, A. L. Barrick, J. Rader, ... and G. G. Koch, "Effect of person-centered showering and the towel bath on bathing-associated aggression, agitation, and discomfort in nursing home residents with dementia: A randomized, controlled trial," Journal of the American Geriatrics Society, Vol.52, No.11, pp.1795-1804, 2004.

상세보기
H. K. Normann, A. Norberg, and K. Asplund, "Confirmation and lucidity during conversations with a woman with severe dementia," Journal of Advanced Nursing, Vol.39, No.4, pp.370-376, 2002.

상세보기
P. J. Doyle and R. L. Rubinstein, "Person-centered dementia care and the cultural matrix of othering," The Gerontologist, Vol.54, No.6, pp.952-963, 2014.

상세보기
D. Brooker, "What is person-centred care in dementia?," Reviews in Clinical Gerontology, Vol.13, No.3, pp.215-222, 2003.

상세보기
B. McCormack, "Person-centredness in gerontological nursing: an overview of the literature," Journal of clinical nursing, Vol.13, pp.31-38, 2004.

상세보기
D. Edvardsson, B. Winblad, and P. O. Sandman, "Person-centred care of people with severe Alzheimer's disease: current status and ways forward," the Lancet neurology, Vol.7, No.4, pp.362-367, 2008.

상세보기
J. M. Corbin and A. Strauss, "Grounded theory research: Procedures, canons, and evaluative criteria," Qualitative sociology, Vol.13, No.1, pp.3-21, 1990.

상세보기
D. N. Ripich, M. Wykle, and S. Niles, "Alzheimer's disease caregivers: The FOCUSED program: A communication skills training program helps nursing assistants to give better care to patients with Alzheimer's disease," Geriatric Nursing, Vol.16, No.1, pp.15-19, 1995.

상세보기
B. S. Kim and H. H. Kim, "Recent Research Trends in Dementia Discourse: Tasks, Transcription and Measures," The Journal of the Korea Contents Association, Vol.15, No.9, pp.351-363, 2015.
S. Sharp, M. Mcallister, and M. Broadbent, "The tension between person centred and task focused care in an acute surgical setting: A critical ethnography," Collegian, Vol.25, No.1, pp.11-17, 2018

상세보기
C. A. Surr, A. W. Griffiths, and R. Kelley, "Implementing Dementia Care Mapping as a practice development tool in dementia care services: a systematic review," Clinical Intervention of Aging, Vol.13, pp.165-177, 2018
S. R. Sabat and M. Collins, "Intact social, cognitive ability, and selfhood: A case study of Alzheimer's disease," American Journal of Alzheimer's Disease, Vol.14, No.1, pp.11-19, 1999.

상세보기
H. K. Normann, N. Henriksen, A. Norberg, and K. Asplund, "Lucidity in a woman with severe dementia related to conversation. A case study," Journal of clinical nursing, Vol.14, No.7, pp.891-896, 2005.

상세보기
P. D. Sloane, B. Hoeffer, C. M. Mitchell, D. A. McKenzie, A. L. Barrick, J. Rader, ... and G. G. Koch, "Effect of person-centered showering and the towel bath on bathing associated aggression, agitation, and discomfort in nursing home residents with dementia: A randomized, controlled trial," Journal of the American Geriatrics Society, Vol.52, No.11, pp.1795-1804, 2004.

상세보기

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증